2024-10-30T09:54:41-05:00 2023-12-31 873231666 PKF O'CONNOR DAVIES ADVISORY LLC 500 MAMARONECK AVENUE SUITE 301 HARRISON NY 105281633 990 2023-01-01 134034061 AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC AMST 2125753322 1060 AMSTERDAM AVENUE NEW YORK NY 10025 MARK PANCIRER SENIOR VP/CFO 2125753322 2024-10-30 1 1 MELISSA MODELSON P01603524 9143818900 2024-10-28 2023 2024-10-15 13:58:12Z JAMES DAVIS 1060 AMSTERDAM AVENUE NEW YORK NY 10025 830522 0 X N/A X 1997 NY SUPPORT TO INDEPENDENT NOT-FOR-PROFITS DEVOTED TO THE HEALTH CARE, HOUSING, AND SERVICESOF THE ILL, THE IMPAIRED, THE DISABLED, AND THE ELDERLY. X 4 4 3 8 0 0 162045 117760 0 0 24640 151137 -9573 -14485 177112 254412 41083 8800000 0 0 12853 33251 0 0 0 61728 1524942 115664 10358193 61448 -10103781 2390985 1043286 2270058 11025798 120927 -9982512 THE PURPOSES OF ACCHS INCLUDE THE PROVISION OF ADVISORY AND OTHER SUPPORT TO INDEPENDENT NOT-FOR-PROFIT ORGANIZATIONS DEVOTED TO THE PROVISION OF HEALTH CARE, HOUSING, AND SERVICES TO THE ILL, THE IMPAIRED, THE DISABLED, AND THE ELDERLY. 0 0 8815514 8800000 0 SUPPORT SERVICES TO RELATED FACILITY-BASED LONG-TERM CARE SERVICE PROVIDERS. 8815514 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 1 6 0 3 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 4 4 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 NY X X MARK PANCIRER 2125753322 1060 AMSTERDAM AVENUE NEW YORK NY 10025 JOSEPH C HOOPES JR CHAIRMAN & TREASURER 2.00 4.25 X X 0 0 0 FRANCES R OLIVIERI VICE CHAIRMAN, THRU 2/8/2023 0.10 1.75 X X 0 0 0 GEORGE L VAN AMSON VICE CHAIRMAN 0.50 1.75 X X 0 0 0 JOSE V TORRES SECRETARY, THRU 2/8/2023 0.10 0.75 X X 0 0 0 LANGDON VAN NORDEN SECRETARY 0.50 1.25 X X 0 0 0 REV CANON JAMES CALLAWAY JR DIRECTOR, THRU 2/8/2023 0.10 1.25 X 0 0 0 R SCOTT EDMONDS DIRECTOR 0.50 1.25 X 0 0 0 JAY H MCDOWELL DIRECTOR, THRU 2/8/2023 0.10 1.25 X 0 0 0 JAMES DAVIS PRESIDENT / CEO 10.00 30.00 X 7555 846975 7863 MARK PANCIRER SR. VP. / CFO 5.00 30.00 X 6154 297817 9763 PAMELA LANDMAN SR. VP. / GENERAL COUNSEL 6.18 54.65 X 0 308935 47800 13709 1453727 65426 0 0 1 0 OTTERBOURG PC 230 PARK AVENUE NEW YORK NY 10169 LEGAL SERVICES 125000 1 117760 117760 152837 152837 539300 541000 -1700 -1700 -1700 20625 117760 35110 -14485 -14485 254412 0 0 136652 8800000 8800000 10839 10839 17000 17000 3064 3064 2348 2348 1446695 1446695 13100 13100 2258 2258 4763 4763 15502 15502 664 664 15514 15514 26446 26446 10358193 8815514 1542679 0 148866 89490 2190370 892112 18403 37200 53721 42951 26284 10770 7062 13714 2390985 1043286 2458 1258198 0 7500000 2267600 2267600 2270058 11025798 X 120927 -9982512 0 0 120927 -9982512 2390985 1043286 -10103781 342 0 X 0 0 0 X 323748 242830 130230 162045 117760 976613 323748 242830 130230 162045 117760 976613 301400 675213 92710 25145 2124 24640 152837 297456 0 1196 0 0 0 1196 1275265 940760 0.52950 0.51990 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 53721 42951 10770 10770 SUBVENTION - SUBORDINATE NOTE 2267600 2267600 ANNUAL GOLF OUTING 138385 117760 20625 17807 11881 5422 138385 117760 20625 17807 11881 5422 35110 -14485 1 AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC 300 EAST OVERLOOK PORT WASHINGTON NY 11050 113711764 501(C)(3) 8800000 0 GENERAL SUPPORT 1 0 PART I, LINE 2: GRANTS TO ORGANIZATIONS: THE HEALTH SYSTEM GAVE A CONTRIBUTION TO A RELATED ORGANIZATION, AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY, INC. THE ORGANIZATIONS HAVE OVERLAPPING MANAGEMENT AND BOARD MEMBERS, WHICH IS HOW THE HEALTH SYSTEM ENSURES THAT THE ORGANIZATION WILL USE THE FUNDS FOR THE INTENDED PURPOSE. THE HEALTH SYSTEM ALSO REQUIRES SUFFICIENT DOCUMENTATION FROM THE GRANTEE PRIOR TO REIMBURSEMENT OF EXPENDITURES. X X X 0 0 0 0 0 0 0 0 0 JAMES DAVIS PRESIDENT / CEO 5380 594945 0 14224 2175 237806 0 0 1464 6399 9019 853374 0 0 PAMELA LANDMAN SR. VP. / GENERAL COUNSEL 0 272820 0 13504 0 22611 0 0 2324 45476 2324 354411 0 0 MARK PANCIRER SR. VP. / CFO 2690 263484 0 12548 3464 21785 0 0 1305 8458 7459 306275 0 0 CASH 2023-12-14 8800000 BOOK VALUE 113711764 AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC 300 EAST OVERLOOK PORT WASHINGTON NY 11050 501(C)(3) 1 0 0 0 PART II, LINE 2E: PERSON(S) INVOLVED: (A) JOSEPH C. HOOPES, GEORGE L. VAN AMSON, R. SCOTT EDMONDS, LANGDON VAN NORDEN. PART II, LINE 2E: EXPLANATION OF INVOLVEMENT: (B) THE ABOVE DIRECTORS ARE ALSO DIRECTORS OF THE TRANSFEREE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B AMSTERDAM CONTINUING CARE HEALTH SYSTEM, INC. HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, A COPY OF THE FORM 990 IS PROVIDED TO AND REVIEWED BY THE AUDIT COMMITTEE. ANY ISSUES ARE REVIEWED AND CORRECTED. THE CFO THEN MAKES THE FULL 990 AVAILABLE TO ALL BOARD MEMBERS PRIOR TO FILING. ONCE THE BOARD HAS APPROVED THE RETURN IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS, OFFICERS, AND KEY PERSONS MUST COMPLETE AN ANNUAL DISCLOSURE AND AFFIRMATION FORM IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY. AN INTERESTED DIRECTOR MEANS ANY AMSTERDAM DIRECTOR WHO HAS AN INTEREST AS A PRINCIPAL, PARTNER, DIRECTOR, OFFICER, EMPLOYEE, AGENT, OR STOCKHOLDER (OTHER THAN A STOCKHOLDER OF A PUBLICLY TRADED CORPORATION WHOSE STOCK IS WIDELY HELD) OF ANY ENTITY WITH WHICH AMSTERDAM HAS OR CONTEMPLATES TRANSACTING BUSINESS. AN INTERESTED DIRECTOR MUST DISCLOSE THE RELATIONSHIP OR INTEREST IN THE TRANSACTION TO THE BOARD OF DIRECTORS. DISCLOSURE SHALL BE MADE TO THE CHAIRMAN OF THE BOARD AS SOON AS THE INTERESTED DIRECTOR BECOMES AWARE OF THE POTENTIAL FOR A CONFLICT IN CONNECTION WITH THE TRANSACTION, WHO THEN SHALL INFORM THE BOARD. IF THE CHAIRMAN IS INVOLVED IN THE TRANSACTION, THE CHAIRMAN SHALL ADVISE THE SECRETARY, WHO SHALL ARRANGE FOR BOARD DISCLOSURE. NO INTERESTED DIRECTOR SHALL PARTICIPATE IN THE DISCUSSION, DELIBERATIONS AND VOTING REGARDING A TRANSACTION. THE AFFIRMATIVE VOTE OF THE MAJORITY OF ALL THE DIRECTORS SHALL BE REQUIRED BEFORE ENTERING INTO THE TRANSACTION (EXCLUDED IN SUCH COUNTS IS THE INTERESTED DIRECTOR). NO TRANSACTION SHALL BE INVALIDATED OR AFFECTED IN ANY WAY IF THIS POLICY IS FOLLOWED. ALL OFFICERS AND PERSONS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS OR SOONER IF A POTENTIAL CONFLICT OR ACTUAL CONFLICT SHOULD ARISE. POTENTIAL CONFLICTS OR ACTUAL CONFLICTS ARE REVIEWED BY THE COMPLIANCE OFFICER. EXECUTIVE EMPLOYEES ARE ALSO REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST ON AN ANNUAL BASIS OR SOONER IF A POTENTIAL CONFLICT OR ACTUAL CONFLICT SHOULD ARISE. FORM 990, PART VI, SECTION B, LINE 15 ACCHS HAS A PROCESS TO DETERMINE COMPENSATION FOR THE PRESIDENT/CEO WHICH INCLUDES A REVIEW BY A COMPENSATION COMMITTEE, AND OUTSIDE BENEFITS CONSULTANT, AND THE USE OF COMPARABLE DATA. THIS PROCESS INCLUDES A REVIEW OF TOTAL COMPENSATION INCLUDING BONUS CONSIDERATION BY THE COMMITTEE. THE DELIBERATIONS AND DECISIONS ARE DOCUMENTED WITHIN THE COMMITTEE MINUTES. THIS PROCESS WAS UNDERTAKEN IN DECEMBER 2021 FOR THE YEAR 2021. BASE WAGES WERE TERMINATED EFFECTIVE DECEMBER 31, 2021. ACCHS HAS A PROCESS TO DETERMINE COMPENSATION FOR OFFICERS OTHER THAN THE PRESIDENT/CEO, WHICH INCLUDES A REVIEW BY A COMPENSATION AND BENEFITS CONSULTANT, AND THE USE OF COMPARABLE DATA. THIS PROCESS INCLUDES A REVIEW OF TOTAL COMPENSATION INCLUDING BONUS CONSIDERATION BY THE PRESIDENT/CEO AND ARE DOCUMENTED IN WRITING. THIS PROCESS WAS LAST UNDERTAKEN IN DECEMBER 2020, AS THERE WAS NO CHANGE IN COMPENSATION IN 2021. THE BASE WAGE COMPENSATION WAS TERMINATED EFFECTIVE DECEMBER 31, 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FORM 990 AND FORM 1023 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS ALSO POSTED ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST OR BY CALLING THE ORGANIZATION DIRECTLY. AMSTERDAM 2012 INC 1060 AMSTERDAM AVE NEW YORK NY 10025 461715083 DEV RENT PROP NY 501(C)(3) LINE 10 AMSTERDAM NURSING HOME CORPORATION (1992) 0 AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC 300 EAST OVERLOOK PORT WASHINGTON NY 11050 113711764 ASSIST ELDERLY NY 501(C)(3) LINE 12A, I AMSTERDAM CONTINUING CARE HEALTH SYSTEM INC 1 AMSTERDAM NURSING HOME CORPORATION (1992) 1060 AMSTERDAM AVE NEW YORK NY 10025 133834710 NURSING HOME NY 501(C)(3) LINE 10 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 AMSTERDAM HOUSE CONTINUING CARE RETIREMENT COMMUNITY INC B 8800000 BOOK VALUE